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4390.0 - Private Hospitals, Australia, 2001-02  
Previous ISSUE Released at 11:30 AM (CANBERRA TIME) 31/10/2003   
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NOTES


ABOUT THIS PUBLICATION

This publication presents details from the 2001-02 national census of private hospitals. Three categories of hospitals are identified: acute hospitals, psychiatric hospitals and free-standing day hospital facilities. There are relatively few psychiatric hospitals and some of these are owned by the same parent company. To maintain the confidentiality of their data, psychiatric hospitals are combined with acute hospitals in most tables in this publication.

State level data has been provided, where possible, for each state and territory in this publication. Previous releases have combined SA and NT, and NSW and ACT.

Two new income tables (hospital type and size) are included in the publication this year. This now means that income and recurrent expenditure can be compared by state, hospital type and hospital size. The insurance table for all hospitals has been modified to show a time series to better monitor the effects of changes in policies designed to stimulate usage of private health services.

Any differences between the data given in this publication and the data shown in other reports on hospital activity are due to differences in scope and coverage, relative completeness of the data sources and differing error resolution procedures.


INQUIRIES

For further information about these and related statistics, contact the National Information and Referral Service on 1300 135 070 or Andrew Cumpsty on Brisbane (07) 3222 6374.


SUMMARY OF FINDINGS


INTRODUCTION

This publication presents data for the private hospital sector in 2001-02. Comparable data for public hospitals is available in Australian Hospitals 2001-02, produced by Australian Institute of Health and Welfare (AIHW). According to data in that publication, during 2001-02 nearly four out of every ten hospital patients in Australia were admitted to private hospitals, representing nearly one-third of all days of hospitalisation.

There were 537 private hospitals in operation during 2001-02. These comprised 277 acute hospitals, 24 psychiatric hospitals and 236 free-standing day hospital facilities (tables 2 and 3).

During 2001-02, private hospitals in Australia:

  • treated 2.6 million admitted patients (patient separations)
  • provided 7.2 million days of hospitalisation to these patients (patient days)
  • employed 48,500 staff (full-time equivalent)
  • earned $5,328m in income (revenue)
  • spent $4,996m for recurrent purposes (recurrent expenditure)
  • invested $474m in buildings and other capital assets (capital expenditure).


HOSPITALS

Although the number of private acute and psychiatric hospitals increased during 2001-02, their numbers have followed a downward trend over the past decade. In 2001-02 there were 301 of these hospitals, two more than in the previous year (table 1). This increase is the net result of the opening of 10 new hospitals and the closure of 8 hospitals.

The strong growth in the number of private free-standing day hospital facilities which has been evident for several years, continued during 2001-02, with an increase of 19 hospital facilities to 236 during the year (table 2). This increase provided an extra 76 beds overall. Most of this growth occurred in Queensland with 11 new hospital facilities.

At 30 June 2002, 89% of private acute and psychiatric hospitals were accredited by Australian Council on Healthcare Standards (ACHS), but only 57% of private free-standing day hospital facilities had the same accreditation (table 32).


BEDS

The average number of beds available in acute and psychiatric hospitals during 2001-02 was 24,748, an increase of 1.2% over the previous year. The average number of beds available per hospital remained constant at 82 for 2001-02.

Slightly more than 73% of available beds in private acute and psychiatric hospitals during 2001-02 were in hospitals within the Capital City Statistical Divisions, where 64% of Australia's population lived at 30 June 2002.

In 2001-02, private acute and psychiatric hospitals had an occupancy rate of 75.2%, an increase from 73.1% in the previous year (table 1). In the larger states bed occupancy rates in 2001-02 varied, with South Australia (79.2%) recording the highest.

Private acute and psychiatric hospitals operated by religious or charitable institutions provided 38% of the available beds during 2001-02. The majority of these type of hospitals are large with 54 (71%) having an average of more than 50 beds available (table 4).


PATIENT SEPARATIONS

In 2001-02, there were 2.1 million patient separations from private acute and psychiatric hospitals. Total patient separations for 2001-02 increased by 8% from 2000-01, compared with an increase of 9% between 1999-2000 and 2000-01. The average annual growth rate for the 5 years to 2001-02 was 7%.

The 8% increase in separations from private acute and psychiatric hospitals comprised a 14% increase in same-day patients and a 2% increase in overnight-stay patients. This 14% increase in same day separations in 2001-02 was higher than the average annual growth for the 5 years of 10%. The increase in overnight-stay separations, however, was lower than the average annual growth over the same period of 4%. The proportion of same-day patient separations has increased significantly in recent years with same-day patients (52%) now exceeding overnight-stay patients (48%) (table 1).

Patient separations from free-standing day hospital facilities during 2001-02 numbered 433,300. This is a 10% increase on the previous year, although lower than a 13% increase between 1999-2000 and 2000-01. The average annual growth rate for the 5 years ending 2001-02 was 14% (table 2).

Graph - all private hospitals, separations



PATIENT DAYS AND AVERAGE LENGTH OF STAY IN HOSPITAL

During 2001-02, 6.8 million patient days were provided in private acute and psychiatric hospitals, an increase of 4.1% from 2000-01.

The average length of stay for all patients (same-day and overnight-stay) in private acute and psychiatric hospitals was 3.2 days, compared with 3.3 in the previous year. Since 1991-92, the average length of stay has gradually decreased from 4.2 to 3.2 days. For overnight-stay patients, the average length of stay remained at 5.6 days, the same as the previous year (table 1).

Across the larger states the average ranged from 3.4 days in both Queensland and South Australia to 3.0 days in Western Australia (table 5).


PATIENT CHARACTERISTICS


Age and sex

Females accounted for 55% of all separations from private acute and psychiatric hospitals and 57% of separations from private free-standing day hospital facilities during 2001-02 (table 28).

Persons aged 65 years and over accounted for 34% of all separations from private acute and psychiatric hospitals and 31% of separations from private free-standing day hospital facilities during 2001-02 (table 28).


Insurance status

During 2001-02, 80% of admitted patient separations from private acute and psychiatric hospitals carried hospital insurance. This proportion has increased from 76% in 1997-98. In 1998-99 the figure dropped to a lowpoint of 73% (table 27).

For free-standing day hospital facilities 63% of admitted patient separations carried hospital insurance with the proportion increasing from 56% in 1997-98. In 1998-99 the proportion dropped to a lowpoint of 53% (table 27).

The proportion of patient separations with hospital insurance for all private hospitals was 77% (table 27).

Graph - Private hospitals, hospital insurance



Procedures performed

For 2001-02 there were 5.2 million procedures performed on the 2.6 million patients admitted to private hospitals. Of these procedures, 4.4 million were performed in acute and psychiatric hospitals and the remainder in free-standing day hospital facilities (table 30).

For acute and psychiatric hospitals, non-invasive, cognitive and interventions, nec (Blocks 1820-1916) account for 40.5% of all procedures performed in private acute and psychiatric hospitals in 2001-02. Examples of cognitive and non-invasive interventions are services such as dietary education and exercise therapy (often used for development of treatment plans, programs, case reviews or follow up to previous procedures performed). For further details of the classification refer to Volume 1 International Statistical Classification of Diseases and Related Health Problems, 10th Revision-Australian Modification (ICD-10-AM).

The next most common procedures in acute and psychiatric hospitals were on the digestive system (11.4%), the musculoskeletal system (6.9%) and gynaecological procedures (4.7%).

For private free-standing day hospital facilities, non-invasive, cognitive and interventions, nec account for 34.1% of all procedures performed on patients, with procedures on the digestive system (24.3%), the eye and adnexa (8.3%) and dermatological and plastic procedures (8.3%) being the other relatively more frequent procedures (table 30).


STAFF

The number of full-time equivalent staff employed at private acute and psychiatric hospitals in Australia during 2001-02 was 46,700, an increase of 2,000 on the previous year (table 1). The average number of staff per occupied bed was 2.5 (table 10).

During 2001-02, there were approximately 1,800 full-time equivalent staff in free-standing day hospital facilities, an increase of 13% on the previous year (table 2). This is in contrast to the previous year where staff numbers increased by 4%.


INCOME

Income received by private acute and psychiatric hospitals in Australia during 2001-02 amounted to $5,066m, an increase of 12% over the previous year. Over the five years to 2001-02, the average annual increase in income was 8% (table 1).

Graph - Acute and psychiatric hospitals, income and expendiuture



Free-standing day hospital facilities received $262m in income during 2001-02. This was a 17% increase on the previous year, consistent with a 17% average annual increase in income over the five years to 2001-02 (table 2).

These increases in income reflect the continuing growth in patient activity for both private acute and psychiatric hospitals, and private free-standing day hospitals, over the last year, and the expansion in available facilities.

Graph - Free-Standing Day Health Facilities, Income and expenditure



EXPENDITURE

Recurrent expenditure for acute and psychiatric hospitals during 2001-02 amounted to $4,777m, an 11% increase over the previous year. When costs are adjusted to remove the effects of price changes over the period, the increase is 8%. (See Explanatory Notes, paragraph 16, concerning chain volume measures). Over the five years to 2001-02, the average annual increase in recurrent expenditure was 9% (6% when adjusted for price changes) (table 1).

In 2001-02, private acute and psychiatric hospitals wages and salaries (including on-costs such as employer contributions to superannuation and payroll tax) accounted for 55% of total recurrent expenditure (table 14). Other large components were drug, medical and surgical supplies (21% of total) and administrative expenses (8%).

The average expenditure per patient day in 2001-02 was $703 compared with $657 in 2000-01. These average costs have increased from $552 in 1997-98 (table 1).

Typically, the average cost per patient day increases as hospital size increases. This is a reflection of the greater complexity of procedures undertaken at the larger hospitals. The more complex procedures necessitate greater use of highly trained staff, expensive equipment, drugs and medical supplies. In 2001-02, recurrent expenditure per patient day at private acute and psychiatric hospitals with over 200 beds was $826 compared with the average of $451 for hospitals with 25 or fewer beds (table 16).

There are also considerable differences in the average recurrent expenditure per patient day among the various hospital types. Religious or charitable hospitals had the highest average costs per patient day ($779) in 2001-02 (table 15). Other non-profit hospitals and hospitals operated for profit had lower average costs per patient day ($694 and $649 respectively). A higher proportion of religious or charitable hospitals are large hospitals (more than 200 beds).

Gross capital expenditure for private acute and psychiatric hospitals during 2001-02 increased 5% to $447m, but remained well short of the record high of $528m during 1998-99 (table 1). Capital expenditure in 2001-02 represented 9% of the total income for that year.

Recurrent expenditure recorded for free-standing day hospital facilities in 2001-02 was $219m. This represents an increase of 20% on the previous year (16% when adjusted for price changes). This compares with the average annual increase of 18% (15% when adjusted for price changes) over the 5 year period to 2001-02. The average expenditure per patient separation increased from $465 in 2000-01 to $506 (table 2).

Gross capital expenditure for free-standing day hospital facilities during 2001-02 was $27m (table 2).


NET OPERATING MARGIN

Net operating margin is derived by subtracting recurrent expenditure from income and expressing the result as a proportion of income. The net operating margin for acute and psychiatric hospitals during 2001-02 was 6%, slightly higher than the previous year of 5%, but in line with the margin for the five years to 2001-02 of 6%.

For free-standing day hospital facilities, the net operating margins were much higher. In 2001-02, the margin was 16%, down from 18% the previous year, but in line with the margin for the five years to 2001-02 of 16%.

Graph - Private Hospitals, Net operating margin





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